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1、·1196·ChineseJournalofReparativeandReconstructiveSurgery,2006,Vol20(12)手指皮瓣分类和急诊修复胡鸿泰张涤生【摘要】目的选择应用伤指本体皮瓣和邻指皮瓣重建指端缺损的方式,总结临床应用疗效。方法2001年8月～2005年6月,收治108例112指手外伤,其中男68例71指,女40例41指;年龄16～63岁。损伤原因:均为切削、挤压和撕脱伤,伤后2h内手术。采取9种皮瓣,对手指指端的急性软组织损伤缺损进行修复.将皮瓣分为两大类:①指动脉主干血管营养皮瓣,包括:指神经血管束V2Y岛状提升瓣,指动脉逆行皮瓣,改
2、良Moberg皮瓣和指神经血管束蒂双翼皮瓣,皮瓣范围210cm×115cm;②指动脉侧支血管营养皮瓣,包括:拇指尺背侧动脉逆行皮瓣,皮瓣范围:115cm×115cm～310cm×215cm,指动脉背侧支逆行皮瓣,皮瓣范围117cm×110cm～415cm×310cm;指掌横支皮瓣,其皮瓣范围:210cm×110cm～215cm×210cm;食指背岛状皮瓣和手指局部皮瓣。结果术后3指坏死,3指浅表性坏死。其余106指移位完全成活。术后随访2周～8个月,皮瓣两点辨别觉5～10mm,指活动良好,外观令人满意。结论选择上述皮瓣可修复所有的末节指端软组织缺损创面,并获得良好的修复
3、外形。【关键词】指创伤指本体皮瓣修复中图分类号:R658.2R622文献标识码:ACLASSIFICATIONOFFINGERFLAPSANDITSUSEINEMERGENCYTREATMENTFORFINGERINJURIESöHUHongtai,ZHANGDisheng.DepartmentofPlasticandReconstructiveSurgery,NinthAffiliatedPeople'sHospital,SchoolofMedicine,ShanghaiJiaotongUniversity,Shanghai,200011,P.R.ChinaCorre
4、spondingauthor:HUHongtai,E2mail:huhongtai@smmail.cn【Abstract】ObjectiveTochoosethehomo2digitalandthehetero2digitalflapsinthereconstructionofthedistalfingerinjuriesandtosummarizethetreatmentresultsobtainedintheclinicalpractice.MethodsFromAugust2001toJune2005,112injuredfingersin108patients(
5、68males,40females;aged16263years)weresurgicallytreated.Theinjurieswereduetoremotion,crushingoravulsion,andtheyunderwentoperations2hoursaftertheinjuries.Ninekindsofflapsweretakenfromthedorsalorvolaraspectoftheinjuredfingerstocoverthedefectsofthedistalfingers.Theflapsweredividedintotwokind
6、s:①Theflapswerenourishedbythemaindigitalarterialbranches,includingtheV2Yislandflapbasedonthedigitalneurovascularbundles,thereverseddigitalarteryflap,themodifiedMobergflap,andthetwinsflapsbasedonthedigitalgeneralneurovascularbundles(flapsranginginareafrom115cm×210cm);and②Theflapswerenouri
7、shedbythecollateraldigitalarterialbranches,includingthedorsoulnararterialretrogradeflapofthethumb(flapsranginginareafrom115cm×115cmto310cm×215cm)andthereverseflapbasedonthedorsalbranchesofthedigitalartery(flapsranginginareafrom117cm×110cmto415cm×310cm),thevolarflapbasedon
